Provider Demographics
NPI:1083907182
Name:MARQUEZ, BEATRICE (MFT INTERN)
Entity type:Individual
Prefix:MS
First Name:BEATRICE
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 CAROL BAILEY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6809
Mailing Address - Country:US
Mailing Address - Phone:702-472-3137
Mailing Address - Fax:702-434-7231
Practice Address - Street 1:3652 N RANCHO DR STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3178
Practice Address - Country:US
Practice Address - Phone:702-472-3137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI4150106H00000X
NV01767-L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1992095384Medicaid